scholarly journals Adherence to Beers Criteria in Geriatrics: A Retrospective Study in a Saudi Teaching Hospital

Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 97
Author(s):  
Samah Alshehri ◽  
Mohannad Alshibani ◽  
Ghaydaa Magboul ◽  
Albandari Albandar ◽  
Roaa Nasser ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Older Patients ◽  
Adverse Drug Events ◽  
Healthcare Providers ◽  
Tertiary Hospital ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Inflammatory Drugs ◽  
The Mean ◽  
Inappropriate Medications

Background: The aging process makes geriatric populations more prone to various chronic diseases. Such diseases require older patients to be on more medications than any other age group and make them more susceptible to adverse drug events related to potentially inappropriate medications (PIMs). Aim: To identify the prevalence of potentially inappropriate medications among older people and explore the most commonly prescribed PIMs in hospitalized patients. Design and Setting: A retrospective study conducted in a large tertiary hospital among patients hospitalized in a 4 year period from January 2015 to December 2018. Methods: The 2019 Beers Criteria were used to assess PIMs in all inpatient prescribed medications focusing on the first class (i.e., drug/drug class to be avoided in older adults). Results: The mean age was 75.17 ± 7.66 years. A total of 684 (80.6%) patients were prescribed at least one medication listed in the first-class category of the 2019 Beers Criteria. Top five drugs were proton pump inhibitors (40.3%), nonsteroidal anti-inflammatory drugs (10.2%), metoclopramide (9.3%), benzodiazepines (8.4%), and insulin (5.4%). Conclusions: The prevalence of PIMs is high among older patients admitted to the hospital. More efforts are needed to investigate the potential reasons and develop action plans to improve concordance to Beers Criteria among healthcare providers.

Potentially inappropriate medications in older adults: A review of the 2012 Beers Criteria and the implications in persons with dementia

2014 ◽  
Vol 4 (4) ◽  
pp. 166-169 ◽  
Author(s):  
Nicole J. Brandt ◽  
Traci Turner
Keyword(s):  
Older Adults ◽  
Adverse Drug Events ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Clinical Tool ◽  
Drug Classes ◽  
Information Set ◽  
Sliding Scale ◽  
Institutionalized Patients ◽  
Inappropriate Medications

In 2012, the American Geriatrics Society (AGS), along with a panel of 11 experts, updated the Beers Criteria which has evolved significantly since its inception in 1991. The Beers Criteria, in general, classifies medications/medication classes as: (1) potentially inappropriate for use in all older adults, (2) potentially inappropriate for older adults with certain diseases or symptoms and (3) requiring extra caution when used in older adults. Although each patient must be evaluated individually, the Beers Criteria is a useful clinical tool that can be used when initiating pharmacologic agents in both ambulatory and institutionalized patients. The concept behind use of the Beers Criteria is that it allows prescribers to readily identify, and avoid, medications associated with negative outcomes in older adults therefore decreasing the risk of adverse drug events (ADEs). Within this review article, there will be a highlight of potentially inappropriate medications (PIMs) commonly seen in clinical practice settings such as antipsychotics, benzodiazepines, non-benzodiazepine sedative-hypnotics, anticholinergics and sliding scale insulin. The focus will be to outline the risk-benefits of these drug classes within the context of persons with dementia. Furthermore, the use of PIMs has both clinical and financial implications in Medicare Star ratings and Healthcare Effectiveness Data and Information Set (HEDIS) measures.

scholarly journals Potentially inappropriate medications use and its associated factors among geriatric patients: a cross-sectional study based on 2019 Beers Criteria

Pharmacia ◽  
2021 ◽  
Vol 68 (4) ◽  
pp. 789-795
Author(s):  
Heba Khader ◽  
Luai Z. Hasoun ◽  
Ahmad Alsayed ◽  
Mahmoud Abu-Samak
Keyword(s):  
Geriatric Patients ◽  
Adverse Drug Events ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Sample Population ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Sectional Study ◽  
Cross Sectional ◽  
Inappropriate Medications

The aims of this study were to estimate the prevalence of potentially inappropriate medications (PIMs) in a community-dwelling Jordanian population of geriatrics according to the 2019 American Geriatrics Society Beers Criteria, to identify the most used PIMs and factors independently associated with PIMs use. This was an observational, descriptive, cross-sectional study. The sample population included 386 participants. Data were collected by face-to-face interviews. A total of 2894 medications were evaluated. The prevalence of patients using at least one PIM was 49.2%. The most used PIMs were proton pump inhibitors (24.6%) and long-acting sulfonylurea (20.5%). Participants who had diabetes mellitus, peptic ulcer, or irritable bowel syndrome had significantly higher numbers of PIMs. The use of PIMs was high in Jordanian geriatric patients. The results of this study might help healthcare providers to detect high-risk patients and reconsider the necessity of using PIMs to decrease the risk of adverse drug events.

PS-069 Potentially inappropriate medications in primary care older patients in toledo (SPAIN): the stopp-start criteria compared with the beers criteria

2015 ◽  
Vol 22 (Suppl 1) ◽  
pp. A163.3-A164
Author(s):  
M Lafuente Gonzalez ◽  
M Ferrit Martin ◽  
F Orantes Casado De Amezua ◽  
M Calleja Hernández ◽  
M Zuzuarregui Girones
Keyword(s):  
Primary Care ◽  
Older Patients ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Start Criteria ◽  
Inappropriate Medications

ASSESSMENT OF DRUG THERAPY IN PSYCHIATRIC ELDERLY PATIENTS BASED ON THE AGS BEERS CRITERIA

2020 ◽  
pp. 325-330
Author(s):  
О. О. Кирилочев
Keyword(s):  
Elderly Patients ◽  
Psychiatric Patients ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Study Objective ◽  
Frequency Of Use ◽  
Benzodiazepine Derivatives ◽  
Inflammatory Drugs ◽  
Inappropriate Medications

Целью исследования явился анализ частоты назначений потенциально не рекомендованных лекарственных препаратов (ПНЛП) лицам пожилого возраста, находящимся на лечении в условиях психиатрического стационара. Данная работа проведена с помощью инструмента по борьбе с полипрагмазией - критериев Бирса, созданного под эгидой Американской гериатрической ассоциации. Исследование свидетельствует о высокой частоте применения ПНЛП следующих фармакологических групп: бензодиазепиновые производные, нестероидные противовоспалительные препараты (длительный приём), а также лекарственные средства с выраженным антихолинергическим потенциалом. Использование критериев Бирса может способствовать оптимизации лечения пожилых пациентов психиатрического профиля и повышению безопасности фармакотерапии. The study objective was to analyze the frequency of prescription of potentially inappropriate medications (PIMs) to elderly patients treated in a psychiatric in-patient setting. This study was carried out using AGS Beers criteria, an anti-polypharmacy tool developed under the auspices of the American Geriatric Association. The study indicates a high frequency of use of PIMs from the following pharmacological groups: benzodiazepine derivatives, non-steroidal anti-inflammatory drugs (long-term use), as well as drugs with significant anticholinergic potential. The AGS Beers criteria can help optimize the treatment for older psychiatric patients and increase the safety of pharmacotherapy.

scholarly journals Potentially inappropriate medications in older patients based on Beers criteria: a cross-sectional study of a family medicine practice in Saudi Arabia

BJGP Open ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. bjgpopen20X101009
Author(s):  
Atheer Alturki ◽  
Tareef Alaama ◽  
Yousef Alomran ◽  
Ahmed Al-Jedai ◽  
Hajer Almudaiheem ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Family Medicine ◽  
Older Patients ◽  
Cross Sectional Study ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Sex ◽  
Inappropriate Medications

BackgroundThe use of potentially inappropriate medications (PIMs) is an important issue in older patients who are at risk of adverse drug events.AimTo determine the prevalence of PIM use, according to Beers criteria, among an older population (aged ≥65 years) in a large family medicine setting, and to identify the associated risks.Design & settingA prospective cross-sectional study of patients aged ≥65 years was conducted from June 2017 to June 2018 at the Family and Community Medicine (FCM) clinics of King Saud Medical City (KSMC) in Riyadh, Saudi Arabia.MethodThis cross-sectional study included patients aged ≥65 years who were seen at new appointments or followed-up at the FCM clinics of KSMC in Riyadh, Saudi Arabia. Data were collected by extensive face-to-face interviews and from the patients’ medical records.ResultsA total of 270 older patients aged 72.41 ±6.23 years (mean ±standard deviation [SD]) were included in the present study. The prevalence of PIMs was 60.7% (n = 164). Multivariate analyses identified three independent variables associated with PIMs: incremental age per 5 years (odds ratio [OR] 1.47, 95% confidence intervals [CI] = 1.15 to 1.88; P = 0.002), female sex (OR 1.95, 95% CI = 1.10 to 3.42; P = 0.021), and polypharmacy (OR 8.21, 95% CI = 4.58 to 14.7; P<0.001). The most common PIMs used were 39.4% related to proton pump inhibitors (PPI), 25.2% to diuretics (other than spironolactone), 10.6% to non-steroidal anti-inflammatory drugs (NSAIDs), and 8.7% to aspirin use.ConclusionThis study showed high prevalence of PIMs. Increasing age, female sex, and polypharmacy were found to be significant risk factors for PIM use. The frequency of morbidities was not significantly different among patients with PIMs compared to those without PIMs, except for hypertension and osteoarthritis, which were more common in the PIMs group. The present study reinforces the importance of comprehensive medication management and reviews.

scholarly journals 21 Prevalence of Potentially Inappropriate Medications (PIMs) in Older Palliative Patients, Defined by STOPPFrail Criteria

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Adeline Foo ◽  
Tony O'Brien ◽  
Denis O'Mahony
Keyword(s):  
Older Patients ◽  
Adverse Drug Events ◽  
Hospice Care ◽  
Terminally Ill ◽  
Median Number ◽  
University Teaching ◽  
Lipid Lowering ◽  
High Dose ◽  
Potentially Inappropriate Medications ◽  
Inappropriate Medications

Abstract Background Polypharmacy is common in older persons with multi-morbid illness, increasing the risk of adverse drug events. Drug pharmacokinetics and pharmacodynamics are often altered in this group increasing the risk of adverse drug events and many prescribed drugs take considerable time to benefit. STOPPFrail criteria are designed to help prescribers to identify potentially inappropriate medications in older sicker patients with short life expectancy. The aim of this pilot study was to estimate the prevalence of STOPPFrail defined potentially inappropriate medications (PIMs in older patients with terminal illness at the point of admission to specialist hospice care. Methods We conducted a prospective analysis of inpatient case records and drug kardexes at a university teaching hospice over a period of one month. We recorded patients’ demographic details, principal symptoms, co-morbidities, medications at admission and at day 3-7. STOPPFrail criteria were applied to patients’ medications lists at both time points. Results Of 22 patients studied, 13 were female with a mean (+/- SD) age of 80 years (+/- 6). Eighteen patients were transferred directly from an acute hospital, 4 patients from the community. Common symptoms were pain (72%) and severe lethargy (68%). Twenty out of 22 patients had cancer as the life-limiting condition. There was a significant reduction in the mean (+/- SD) number of medications from admission (11 ± 4.1) to post palliative review (8 ± 4.7; p=0.002). 90% of patients had polypharmacy i.e. ≥ 6 daily medications, 87% had ≥ 1 STOPPFrail PIM on admission. The median number of STOPPFrail PIMs per patient was 1 (1-2, IQR), most commonly high dose proton pump inhibitors, multivitamin supplements, calcium supplements and lipid lowering therapies. Conclusion In this small study, STOPPFrail-defined PIMs were highly prevalent in older terminally ill patients. Prescribers should carefully review the medication lists of terminally ill older patients in order to minimize inappropriate polypharmacy.

Associations Between Potentially Inappropriate Medications and Adverse Health Outcomes in the Elderly: A Systematic Review and Meta-analysis

2019 ◽  
Vol 53 (10) ◽  
pp. 1005-1019 ◽  
Author(s):  
Xiao Xuan Xing ◽  
Chen Zhu ◽  
Hua Yu Liang ◽  
Ke Wang ◽  
Yan Qi Chu ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Adverse Drug Events ◽  
The Elderly ◽  
Adverse Outcomes ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Inclusion Criteria ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Inappropriate Medications

Background: Adverse drug outcomes in the elderly have led to the development of lists of potentially inappropriate medications (PIMs), such as the Beers criteria, and these PIMs have been studied widely; however, it is still unclear whether PIM use is predictive of adverse outcomes in older people. Objective: To qualitatively examine the associations between exposure to PIMs from the general Beers criteria and the Screening Tool of Older Persons’ Prescriptions list and adverse outcomes, such as adverse drug reactions (ADRs)/adverse drug events (ADEs), hospitalization, and mortality. Methods: Specified databases were searched from inception to February 1, 2018. Two reviewers independently selected studies that met the inclusion criteria, assessed study quality, and extracted data. Data were pooled using Stata 12.0. The outcomes were ADRs/ADEs, hospitalization, and mortality. Results: A total of 33 studies met the inclusion criteria. The combined analysis revealed a statistically significant association between ADRs/hospitalizations and PIMs (odds ratio [OR] = 1.44, 95% CI = 1.33-1.56; OR = 1.27, 95% CI = 1.20-1.35), but no statistically significant association was found between mortality and PIMs (OR = 1.04; 95% CI = 0.75-1.45). It is interesting to note that the results changed when different continents/criteria were used for the analysis. Compared with the elderly individuals exposed to 1 PIM, the risk of adverse health outcomes was much higher for those who took ≥2 PIMs. Conclusion and Relevance: We recommend that clinicians avoid prescribing PIMs for older adults whenever feasible. In addition, the observed associations should be generalized to other countries with different PIM criteria with caution.

Application of STOPP Criteria and Beers Criteria in an inpatient psychiatric facility and impact on utilization of potentially inappropriate medications and adverse outcomes

2014 ◽  
Vol 4 (4) ◽  
pp. 201-206 ◽  
Author(s):  
Morgan C. Snyder ◽  
Lisa M. Mican ◽  
Tawny Smith ◽  
Jamie Barner
Keyword(s):  
Geriatric Patients ◽  
Adverse Drug Events ◽  
Adverse Outcomes ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Psychiatric Facility ◽  
Stopp Criteria ◽  
Secondary Outcomes ◽  
Inappropriate Medications ◽  
Inpatient Psychiatric Facility

Background: The Beers Criteria and STOPP Criteria were developed to identify potentially inappropriate medications (PIMs) in the geriatric population. Utilization of STOPP Criteria PIMs have shown a significant association with presence of avoidable adverse drug events (ADEs) as compared to utilization of Beers Criteria PIMs. Objectives: The purpose of this study was to utilize STOPP and Beers Criteria to identify PIMs in geriatric patients at an inpatient psychiatric facility, with the goal of implementing a formal process for assessing medication regimens. This process would be expected to decrease adverse outcomes. Methods: Both criteria were used by the pharmacist to identify PIMs and recommendations were made to address the PIMs. A retrospective chart review evaluated whether utilization of the two criteria led to a significant change in number of PIMs and associated adverse outcomes. The primary outcome was the change in number of PIMs for the Beers Criteria versus the STOPP Criteria. Secondary outcomes included the change in number of PIMs, falls, required referrals/transfers, and medication-specific ADEs for each set of criteria assessed separately. Results: Twenty-nine patients met inclusion criteria, and 76 treatment recommendations were made. More PIMs per patient were identified at baseline utilizing STOPP (mean±SD,3.9±2.3) versus Beers Criteria (mean±SD, 2.2±1.3) (p&lt;0.001). The number of PIMs decreased using STOPP (from 112 to 66; mean decrease per patient −1.6±1.5, p&lt;0.0001) and Beers Criteria (from 63 to 23; mean decrease per patient −1.4±1.1, p&lt;0.0001), although the change was not significant for STOPP vs. Beers (p=0.375). All secondary outcomes decreased using both criteria. Conclusions: Utilization of each set of criteria by the pharmacist led to a significant decrease in PIMs and adverse outcomes decreased at follow-up using both criteria. Implementation of a process for assessing medication regimens of geriatric patients utilizing the Beers and/or STOPP Criteria would likely be beneficial to this institution.

scholarly journals Potentially inappropriate medications in older patients based on Beers criteria at a large family medicine clinic in Saudi Arabia

2019 ◽  
Vol 69 (suppl 1) ◽  
pp. bjgp19X703349
Author(s):  
Atheer Alturki
Keyword(s):  
Saudi Arabia ◽  
Family Medicine ◽  
Older Patients ◽  
Significant Risk ◽  
Large Family ◽  
Future Research ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Female Sex ◽  
Inappropriate Medications

BackgroundThe use of potentially inappropriate medications (PIMs) is an issue especially among older patients who have medical comorbidities. They are more at risk to drug adverse effects compared to younger patients.AimTo determine the prevalence of PIMs use according to Beers criteria among the older population in a large family medicine setting in Saudi Arabia and to identify the associated risk.MethodThis was a prospective cross-sectional study conducted from June 2017 to June 2018. All patients aged ≥65 years who were followed-up at the family medicine clinics were included. The American Geriatrics Society 2015 Updated Beers Criteria were used to determine the PIMs use.ResultsA total of 270 older patients aged 72.41 ± 6.23 years were included in the study. The prevalence of PIMs was 60.7%. Multivariate analyses identified three independent variables associated with PIMs: incremental age per 5 years (odds ratio [OR] = 1.47; 95% confidence interval [CI] = 1.15 to 1.88; P = 0.002), female sex (OR 1.95; 95% CI = 1.10 to 3.42; P = 0.021), and polypharmacy (OR 8.21; 95% CI = 4.58 to 14.7; P<0.001). The most common PIMs used were 39.4% related to proton pump inhibitors (PPIs), 25.2% to diuretics (other than spironolactone), 10.6% to non-steroidal anti-inflammatory drugs (NSAIDs), and 8.7% to aspirin use.ConclusionThis study showed high prevalence of PIMs. Increasing age, female sex, and polypharmacy were found to be significant risk factors for PIMs use. The present study reinforces the importance of comprehensive medication management and reviews. Future research should evaluate interventions aimed at improving primary care follow-up and reducing the prevalence of PIMs.

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